193 BEACH AVE #4 - INTERIOR REMODEL & WINDOWS •
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CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
>:\ INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-RAAR-3664
Job Type: RESIDENTIAL ALTERATION
Description: REMODEL AND REPLACE WINDOWS - NEED N.O.C.
Estimated Value: $50,000.00
Issue Date: 4/7/2017
Expiration Date: 10/4/2017 _
PROPERTY ADDRESS:
Address: 193 BEACH AVE 4
RE Number: None
PROPERTY OWNER:
Name: Travis, Russell L
Address:
GENERAL CONTRACTOR INFORMATION:
Name: NORTH RIVER BUILDING SOLUTIONS
, CGC1518918
Address: 6771 SHINDLER DR QA JOSHUA M HOGAN
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $150.00
BUILDING PERMIT FEE $300.00
STATE DCA SURCHARGE $4.50
STATE DBPR SURCHARGE $4.50
Total Payments: $459.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
City of Atlantic Beach NUMBER
( J-)N
s .; Building Department (To be assigned by the Building Department.)
. 800 Seminole Road. 17 _APPLICATION,
5:y1 Atlantic Beach, Florda 32233-5445 ``t-
Phone(904)247-5826 • Fax(904)247-5845 4 / 3fi 7
x oi319? E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:1 J ECi{ U EItcv D ent review required Yes/'No
ORA
Ru1Lcu\)c ldin 1/Applicant: M OPlvEz ning &Zoning
Tree Administrator
Project: I T-CAOR. R& ro QE Public Works
Public Utilities
V V 1 I .- () ow Public Safety
I
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By _
Florida Dept.of Environmental Protection
Florida Dept. of Transportation _
St.Johns River Water Management District
Army Corps of Engineers _
Division of Hotels and Restaurants
1.
Division of Alcoholic Beverages and Tobacco _
Other:
APPLICATION STATUS
Reviewing Department First Review: K:proved. ❑Denied.
(Circle one.) Comments: iv/A
BUILDIN l-`'
PLANNING &ZONING y tel',612
Reviewed b : , , ` _ Date:
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
•
`,. J
,:-=,4 .,„ . Building Permit Application IL COr'
r City of Atlantic Beach
1-3 — 800 Seminole Road,Atlantic Beach,FL 32233
i,t' Phone: (904)247-5826 Fax: (904)247-5845 �
Job Address: 3 e0-ce. S'Je. Permit Number: I _ {' `PA (0(0
wescg6 am
Legal Description 1034,5 —a9C S kar-t('rPS)- Cort)o r".,.thw.INwtli.%VA.l-4 RE# Ir7631 I- IDO$
Valuation of Work(Replacement Cost)$ <D t` Heated/Cooled SF Zoo 'D() Non-Heated/Cooled
• Class of Work(Circle one): New Addition (as•- Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial AraigentigN,
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes�ifd/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
&GAM- vow Rem(9 . t) e pieta . sa,.e. �e(c •(.a.t
6 .�Ot,�S
,;-1-2.1"-•^1r:1660-5 vt.' l 1yw•s i /‘9,...3! �%, v . o
Florida Product Approval# multiple products use product approval form
Property Owner Informationi
Name: 0-us5{k L jr,,.:,S Address: b a 0 }— (/J _ -
City L e,c). -540%. State V Zip yDSDa._ Phone 8S9 -3 _/- '7% Y
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Informal.tionpp I�
Name of Company: No(+t. V t1 IJu5S d i .{ 501464/Qualifying Agent: Sas L'1 (,t^"'
Address Po &.,..,,, yYod.y 5 �) City 1;44 State C Zip 3,,,2k ca.2
Office Phone Job Site/Contact Number % U 9-,24/ -0799
State Certification/Registration# C.&'G /..C/99/2 E-Mail 4-odol a n I.Aui/d;*.y• La w.
Architect Name&Phone# �j1'
Engineer's Name&Phone# r
Workers Compensation _
Exempt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installat.;on has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
2X/ Inn ��iD _____,..--
(Si
(Signature of Owner or Agent including Contractor)ed sworn to(or affirmed)before me this .3 day of Sig2' ' atureoonractor
worn to(or affirmed)before me this o day of
r 1 G1Y , '7 ,by1.--144.1.,_ $1 �cL aa 1� ,by `/ t ....S....SA_J
-(sivatur or Not�a�ry)___ (Signature of Notary)
• JO'. : MCSWAIN
• f1d MY COMMISSION #FF130406 `"°�`'
r- ;P a'VI JOSEPH TODD MCSWAIN
'•7..?•,M14!:` EXPIRES June 8,2018
>jersonal Alfd f`9 Ql FloridallotaryService.com ersonally Known OR i';?' y•�,•; MY COMMISSION tiFF130406
// .,,«1. •� EXPIRES June 8,2018
[ ]ProduceQ'ItfgfltRleiLIaTI [ ]Produced Identification ,....
Type of Identification: Type of Identification: (407)300 P153 Florida
NOTICE OF COMMENCEMENT
State of r-to r;cl . Tax Folio No.
County of l Q i CA\
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this N TICE OF COMMENCEMENT. l
Legal Description of property being improved: 16 9.S—0L ?E Sk.ore Cn'S� (-..jp...: e)w,,, 'e/_ C v
0112 Ssg6 aI33 QQ
Address of property being improved: 193 rr3eac..L. A-U'e 1 � awl• C. Q P.rn(,� .. 3. ..a.3 3
General description of improvements: 3 .„.44,... f yt•-t, G
/ Y1 t°c...) wi